The World Health Organisation estimates there are approximately 1.1 billion smokers in the world today – and come 2025, the number will be roughly the same.
The best choice any smoker can make is to quit tobacco and nicotine altogether, but many don’t. Adults who would otherwise continue to smoke deserve better, smoke-free alternatives enabled by science and innovation.
Regulation should allow adult smokers to have access to, as well as accurate and non-misleading information about these alternatives and how they compare with cigarettes. They are not risk-free and deliver nicotine, which is addictive. However, they can be a better choice than continued smoking if scientifically substantiated and manufactured under appropriate safety and quality controls.
As it stands today, some governments restrict access to information about them. Further compounding the issue, some tobacco control organisations refuse to consider the innovations coming from the tobacco industry as viable alternatives that governments can use to supplement existing smoking cessation and prevention measures. These together can result in a variety of misconceptions about smoke-free alternatives’ potential to reduce harm.
What happens when a cigarette burns?
Combustion occurs when a cigarette is lit, generating smoke. The smoke formed contains more than 6 000 chemicals, about 100 of which have been classified by public health authorities as harmful or potentially harmful. By eliminating the combustion or burning process – as is the case with smoke-free products – there is no smoke and the levels of harmful chemicals generated can be significantly reduced compared with cigarette smoke. Of course, whether a product reduces emissions of harmful chemicals compared with cigarette smoke has to be scientifically assessed on a product-by-product basis. These products are not risk free and contain nicotine, which is addictive.
Smoke-free alternatives are just that – free of smoke
By not burning tobacco, smoke-free products – such as e-cigarettes, snus and heated tobacco products (HTPs) – don’t create smoke. E-cigarettes (also known as vapes, e-vapor products or electronic nicotine delivery systems) heat a liquid solution containing nicotine and flavours to produce an aerosol, which some call a vapor—hence the term “vaping”. HTPs generate a nicotine-containing aerosol by heating tobacco to temperatures sufficient to release nicotine and flavours from the tobacco, but low enough to prevent the tobacco from burning.
Nicotine in smoke-free products
HTPs and most e-cigarettes contain nicotine. Nicotine is one of the factors, alongside taste and ritual, that plays an important role in switching adult smokers from cigarettes to smoke-free products. In order to switch completely, smokers need to find these products acceptable substitutes for cigarettes.
Nicotine, while addictive and not risk-free, is not the primary cause of smoking-related diseases. This has been recognised by many experts and institutions.
Certain people should not use products that contain nicotine. Minors should not use or have access to tobacco or nicotine-containing products. Nicotine products should not be used by non-nicotine users and should also not be used during pregnancy or while breast-feeding. Nicotine-containing products should not be used by people who have or are at risk of heart disease, are diabetic, are epileptic or experience seizures.
Quitting tobacco and nicotine altogether is the best choice for health. Existing tobacco control measures designed to discourage initiation and encourage cessation should continue. However, despite these efforts, millions of people continue to smoke. Science-backed, smoke-free products can play a role in moving adults who would otherwise continue to smoke away from cigarettes. With the right regulatory encouragement and support from civil society, together we can deliver a smoke-free future more quickly than relying on traditional measures alone.